Individual
LING S ONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1870 WINTON RD S, SUITE 1, ROCHESTER, NY 14618-3960
(585) 442-4690
(585) 442-4692
Mailing address
1870 WINTON RD S, SUITE 1, ROCHESTER, NY 14618-3960
(585) 442-4690
(585) 442-4692
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
115302
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00487105
—
NY
01
—
010115302
BLUE CHOICE PROV ID
NY
01
—
060056872
RAILROAD MEDICARE PROV ID
NY
01
—
115302-2
WORKERS COMPENSATION
NY
01
—
2911
EXCELLUS BSH PROV ID
NY
01
—
5809328
AETNA PROVIDER ID#
NY
01
—
MDE486
PREFERRED CARE PROV ID
NY
Enumeration date
08/09/2005
Last updated
10/27/2010
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